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Overview

"With Lous Heshusius as a guide, pain patients can learn much about the perils of a modern health-care odyssey. Health professionals can learn how an articulate middle-class female white patient thinks (with all that thinking entails) when her world is irreversibly altered by pain. She does not promise happy endings. Chronic pain is like that. From the rare intersection in this text between patient narrative and physician response, however, readers may construct a dialogue on pain in our time that cannot fail to bring plentiful opportunities for personal insight and professional enlightenment."—from the Foreword by David B. Morris

Chronic pain, which affects 70 million people in the United States alone—more than diabetes, cancer, and heart disease combined—is a major public health issue that remains poorly understood both within the health care system and by those closest to the people it afflicts. This book examines the experience of pain in ways that could significantly improve how patients and practitioners deal with pain. It is the first volume of a new collection of titles within the acclaimed Culture and Politics of Health Care Work series called How Patients Think, intended to give voice to the concerns of patients about their own medical care and the formulation of health policy.

Since surviving a near-fatal car accident, Lous Heshusius has suffered from chronic pain for more than a decade, forcing her to give up her career as a professor of education. Inside Chronic Pain, based in part on the pain journal Heshusius keeps, is a stunning memoir of a life lived in constant pain as well as an insightful and often critical account of the inadequacies of the health care system—from physicians to hospitals and health insurance companies—to understand chronic pain and treat those who suffer from it. Through her own frequently frustrating experiences, she shows how health care providers often ignore, deny, or incorrectly treat chronic pain at immense cost to both the patient and the health care system. She also offers cogent suggestions on improving the quality and outcome of chronic pain care and management, using her encounters with exceptional medical professionals as models.

Inside Chronic Pain deals with pain's dramatic and destructive effects on one's sense of self and identity. It chronicles the chaos that takes place, the paralyzing effect of severe pain, the changes in personality that ensue, and the corrosive effects of severe pain on the ability to attend to day-to-day tasks. It describes how one's social life falls apart and isolation takes over. It also relates moments of happiness and beauty and describes how rooting the self in the present is crucial in managing pain.

A unique feature of Inside Chronic Pain is the clinical commentary by Dr. Scott M. Fishman, president of the American Pain Foundation. Fishman has long tried to improve the lives of patients like Heshusius. His medical perspective on her very human narrative will help physicians and other clinicians better understand and treat patients with chronic pain.

Editorial Reviews

From the Publisher

"Great poets have struggled through time to convey the inner experience of ongoing physical pain but Lous Heshusius accomplishes that task. While her writing is steady, educated, and reasoned, her personal reflections pack a cumulative punch to the reader, building on each other to convey layers of frustration, isolation, and struggle. Much of her suffering is not a result of her illness, but the medical system that is more geared toward treating acute pain than the kind that lingers and becomes a chronic illness in its own right. Meanwhile, the book counters entrenched and malignant cultural stereotypes of the female chronic-pain patient as hysterical and chronic pain as absolutely mysterious and inherently 'unknowable,' and thus medically untreatable. Those who haven't suffered chronic pain will get new insight, and long-time 'thick-folder patients' like me will experience a jolt of recognition with every turn of Heshusius's story. This book will be especially useful as a practical users' manual for caregivers to learn about routine, yet powerful, ways to improve patient care, and to address a critical related issue too often brushed under the rug: the high rates of suicide of these patients."—Paula Kamen, author of All in My Head: My Epic Quest to Cure an Unrelenting, Totally Unreasonable and Only Slightly Enlightening Headache and Finding Iris Chang: Friendship, Ambition and the Loss of an Extraordinary Mind

"Inside Chronic Pain is a scholarly work of storytelling. It is shocking, powerful, challenging, and assaulting. Lous Heshusius pulls us into her story with truth and balance, with unrelenting honesty and forthrightness, without weeping in self-pity. Inside Chronic Pain is credible narrative, sprinkled with personal experience, mixing events with reflection and interpretation to reveal, in retrospect, a story that should not have happened, portrayed in chapters relating hardships that should not befall anyone. This is a story of a slow metamorphosis that was triggered by a single event, but which evolved over the ensuing years. The author portrays isolation, fear, depression, sadness, disappointment, anger, and exasperation without drowning in sorrow. This is a pivotal work; I hope that it will prompt or provoke others who live with chronic pain to announce their own experiences. Give pain a voice! This work is a wake-up call from the invisible in our society who live with chronic pain. The author leaves it up to the reader how to respond to this call. If you live with chronic pain, this is a must read. If you do not know chronic pain, this is a must read."—James L. Henry, Scientific Director, Michael G. DeGroote Institute for Pain Research and Care, McMaster University

Related Subjects

Meet the Author

David B. Morris is University Professor of English at the University of Virginia. He is the author of many books, including The Culture of Pain.

Dr. Scott M. Fishman is Chief of the Division of Pain Medicine and Professor of Anesthesiology and Pain Medicine at the University of California, Davis, and President of the American Pain Foundation. He is the author of several books, among them Listening to Pain and The War on Pain.

Table of Contents

Foreword by David B. Morris

Introduction

1. A Life Altered
2. That Which Has No Words, That Which Cannot Be Seen
3. Pain and the Self
4. Pain and the World of Pain Management
5. Pain Medicine
6. On Science and Time
7. Pain and Others
8. Where Are We with Chronic Pain?: A Patient's Perspective

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Customer Reviews

MECO

Posted February 14, 2010

Find the courage to read this book.

That the author is alive is astounding. That she has managed to bear such searing and eloquent witness of her chronic pain from within its crucible, beggars the imagination.
Viktor Frankl said: "Facts are not fate. What matters is the stand we take toward them." In an instant, over a decade ago, the 'facts' of Lous Heshusius' life changed; a car accident transformed her life into an interminable maelstrom of permanent pain. Physical and emotional anguish became her new reality. In such circumstances, it seems to me that merely going on becomes a daily act of supreme (and perhaps unreasonable) courage and yet Heshusius has managed to record the crazy-making plethora of procedures, prognoses and promises offered to her on the merry-go-round of the medical establishment and to research and reflect upon the toll they have taken on her and on the vast numbers of others enduring chronic pain.
I was deeply moved by her chapter on Pain and the Self in which she explores with awe how beauty in music and nature can weave their gentling presence into her, thereby lightening temporarily the burden of her pain.
But the most powerful message for me in Inside Chronic Pain remains her challenge to both the medical and the larger community to move through our reflex to turn aside from the suffering of those in chronic pain and instead to adopt an ethical stance of listening and staying present.

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In her new book, Inside Chronic Pain: An Intimate and Critical Account, Lous Heshusius offers a fascinating account of her journey through the complexities of the medical system and its response to the phenomenon of chronic pain, as well as her personal physical, emotional and intellectual processes as she strove to cope in a society that essentially denies pain as an on-going, all pervasive dilemma in the lives of many. She does not ask the reader to suffer with her, but rather allows us to witness her experience in such a way that I found myself compelled to read on to discover how her life has unfolded. Poignantly, Heshusius articulates the most frightening question: What can I still be? As one who lives with chronic pain, I had not put that question into words, but on reading it, I realized that it summarized all my fears. Her keen insights offer both inspiration and suggestions for coping. Most importantly, she demonstrates that it may be possible to "still be." Inside Chronic Pain is essential reading for everyone in the medical profession and for all of us who share in the chronic pain experience, as well as families, friends and employers. Almost everyone knows someone who lives with persistent pain and this book will help to better understand what they are going through. With 75 million Americans living with daily pain, this book needs to become an essential element of both the popular and public health literature. - L. Mastrianni

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